50716 research outputs found
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Prepare engage process action (PEPA):a co-designed approach to integrating consumer feedback during placements
No full textAuthentically partnering with consumers as co-educators in health students’ education during placements is nuanced, given the diversity of consumers, practice contexts and students. Co-design of educational interventions to address these complexities is required. This research outlines the development of a consumer feedback system created by a co-design team. A co-design team, including a consumer, student, educator, and academic, used design thinking methods to define the problem and created guiding principles to consider when developing a consumer feedback system for placements. The principles were then applied to a local occupational therapy education programme to develop a consumer feedback system specific to their programme. The design team created eight guiding principles for health educators to consider when developing a consumer feedback system for use during placements. Application of these principles is presented using the PEPA System–Prepare, Engage, Process and Action. To our knowledge, this is the first co-designed consumer feedback system that was developed by all collaborators involved in student learning during placements. The PEPA System aims to enhance authentic consumer contribution to learning during placements while addressing the complexity and diversity of all collaborators involved in learning. Further research is required to evaluate the feedback system.</p
A Digital Alert Feedback System (Aged Care Electronic Dashboard Information Tool, ACED-IT) to Enhance Quality Nursing Care:Participatory Action Research
No full textAims: Develop and simulate test a digital alert dashboard drawing from existing data to support nurses, care workers and managers in residential aged care. Design: Participatory action research, co-designing for an Australian 64-bed residential site. Methods: Qualitative data were collected through focus groups and analysed using reflective thematic analysis. Results: Nursing-theory and evidence-based Nursing Data Domain Standards (NDDS) were developed to support internal triaging of fundamental and clinical care in a non-clinical environment. A co-designed retrospective digital alert dashboard (Aged Care Electronic Dashboard Information Tool—ACED-IT) representing the Standards was created and tested. Twenty aged care nurses, care workers and managers found it had promise in enhancing quality of care, improving resident health and reducing adverse events. Conclusions: Maximising efficient use of resident-level data with a system that empowers nurse decision-makers is crucial to support effective care design and harm prevention. Implications for the Profession and/or Patient Care: ACED-IT has the potential to improve visibility of resident needs, support staff to adjust their workflow based on in-house triage, enhance supervision of staff and quality of care and reduce preventable complications. Impact: Digital systems that enable nursing care escalation and triaging for early intervention are needed in residential aged care settings. The co-designed system was perceived by registered nurses, care workers and managers to have the potential to improve care quality and efficiency. Using an evidence-informed nursing framework to identify day-to-day care indicators can be widely implemented by government regulators, software providers and residential care providers on an international scale to improve resident experience. Reporting Method: This study adhered to the relevant EQUATOR guidelines, specifically the COREQ (Consolidated Criteria for Reporting Qualitative Research) Checklist. Patient or Public Contribution: A member of the public participated in the Advisory Group, observed and contributed to the co-design process and reviewed the manuscript.</p
The Effect of Consuming Caffeine Before Late Afternoon/Evening Training or Competition on Sleep:A Systematic Review with Meta-Analysis
No full textMany athletes consume caffeine before late afternoon/evening training sessions or competition, yet the impact on subsequent sleep remains unclear. This systematic review with meta-analysis examined the effects of late afternoon/evening caffeine consumption on sleep in athletes. Ten studies (n = 128 athletes) involving randomized controlled trials and quasi-experimental designs were included if caffeine was consumed prior to late afternoon/evening training and subsequent sleep was measured. Meta-analysis followed PRISMA guidelines with risk of bias assessed using RoB-2 and ROBINS-I tools. Meta-analysis of randomized controlled trials revealed a small reduction in sleep efficiency with evening caffeine consumption: mean difference −4.87%, 95% CI −7.45 to −2.29, p = 0.04, though this effect was not robust in leave-one-out sensitivity analyses. Total sleep time showed a non-significant trend toward reduction: mean difference −32.47 min, 95% CI −69.93 to 4.99, p = 0.08, I2 = 0%. Athletes consistently reported substantial subjective sleep impairment following evening caffeine intake (3–6 mg/kg BM), creating a pronounced objective–subjective disconnect. The most notable finding is that athletes consistently perceive substantial sleep disruption despite inconsistent objective changes, highlighting the importance of subjective sleep experience in athletic populations. These findings should be interpreted cautiously given the small number of studies and predominance of male participants, limiting generalisability.</p
New data shows the US dollar still dominates foreign exchange markets – despite Trump’s economic chaos
No full textHealth benefits of traffic emissions controls in Melbourne, Australia
No full textLong term exposure to traffic related air pollution (TRAP) is associated with respiratory and cardiovascular morbidity and mortality. In 2005 and 2013, Australia adopted Euro 4 and Euro 5 emissions standards, respectively, for all new vehicles, leading to gradual decreases in TRAP concentrations and associated ambient NO2 levels. We estimated the health impacts of those emissions standards in Victoria, Australia and assessed the spatial distribution of benefits. We estimated annual mortality attributable to TRAP under pre-2005 conditions and calculated the years of life gained since. Population weighted annual average NO2 exposures were estimated for each of the years 2005–2022 using a spatial linear regression (SLR) model and the share from vehicles was determined using a chemical transport model. Attributable mortality was estimated using the mortality concentration-response coefficient for NO2 (1.023, 95 % CI: 1.008–1.037, per 10 μg/m3 annual average) as recommended by the Committee on the Medical Effects of Air Pollutants. Across the state, 2005 population weighted average NO2 exposures were 3.8–40.0 μg/m3, and decreased by −1.4–9.7 μg/m3 over the years to 2022. Prior to 2005, the mortality burden of NO2 from all anthropogenic sources (Mean 20.2 μg/m3) was 685 (95 % CI, 243–1084) premature deaths annually, corresponding with 10,355 [3623–16570] years of life lost (YLL), including 9234 [3230, 14,778] from traffic related NO2. Tailpipe emissions controls have led to 11,889 [4170, 18,979] additional years of life among residents of Victoria, Australia, since 2005. But these benefits are concentrated in urban areas with no industry.</p
Exploring Physical Activity Levels, Barriers, and Education Sources in People with Cancer Undergoing Chemotherapy
No full textPurpose: Physical activity (PA) during chemotherapy can lessen side effects, support treatment adherence, and improve overall outcomes, yet the barriers to PA in this population remain underexplored. This study assessed self-reported PA levels, barriers, and sources of PA education among adults with cancer undergoing chemotherapy. Methods: A cross-sectional survey was conducted among adult outpatients receiving chemotherapy in the ACT, Australia. The survey collected demographic information, PA levels using the modified Godin–Shephard Leisure Time Questionnaire, barriers to PA, and sources of PA education. Both quantitative and qualitative analyses were performed. Results: Of 111 participants (mean age 59.2), only 11.7% met ‘active’ PA status and 9.9% met resistance exercise guidelines. Barriers included fatigue, strength, pain, motivation, nausea, and lack of time. Notably, almost one-third received no PA education during chemotherapy, and nearly half wanted more. Education by accredited exercise physiologists increased resistance exercise participation. Conclusions: Few participants met PA recommendations during chemotherapy, with many reporting insufficient PA education and significant barriers. These findings highlight critical gaps in patient care and education. Addressing these through integrated, evidence-based PA programs and policy changes could enhance patient health, improve outcomes, and reduce disparities in supportive cancer care.</p
Exploring Prefrontal Cortex Involvement in Postural Control Across Degraded Sensory Conditions Using fNIRS and Classification
No full textThe prefrontal cortex (PFC) of the brain is involved in processing visual, vestibular, and somatosensory inputs to stabilise postural balance. However, the PFC’s activation map for a standing person and different sensory inputs remains unclear. This study aimed to explore the PFC activity map and distinct haemodynamic responses during postural control when sensory inputs change. To this end, functional near-infrared spectroscopy (fNIRS) was employed to capture the haemodynamic responses throughout the PFC from a group of young adults standing in four sensory conditions. The results revealed distinct PFC activation patterns supporting sensory processing, motor planning, and cognitive control to maintain balance under different degraded sensory conditions. Furthermore, by applying machine learning classifiers and multivariate feature selection, the PFC locations and haemodynamic responses indicative of different sensory conditions were identified. The findings of this study offer valuable insights for optimising rehabilitation approaches, enhancing the design of fNIRS studies, and advancing brain-computer interface technologies for balance assessment and training.</p
What is the effect of measurable respiratory muscle training on respiratory muscle strength in mechanically ventilated adults in intensive care units? A systematic review and meta-analysis
No full textBackground: Respiratory muscle weakness, associated with mechanical ventilation during critical illness, is well established. Respiratory muscle strength training (RMST) including inspiratory muscle training (IMT) and expiratory muscle strength training (EMST) aims to address this weakness. The aim of this systematic review and meta-analysis was to assess the effectiveness of RMST, delivered using measurable load devices, to increase respiratory muscle strength in mechanically ventilated adults in the intensive care unit. Methods: Conducted per Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, the review included randomised controlled trials of intensive care unit patients aged ≥16 years, ventilated ≥24 h, receiving RMST (IMT or EMST) via measurable load devices before extubation, published from January 2000 to January 2024. Preoperative/postoperative training and cohorts with other causes of respiratory weakness were excluded. Searches covered electronic databases, clinical registers, reference lists, and SCOPUS. Meta-analyses and sensitivity and subgroup analyses were performed using Cochrane Review Manager (RevMan). Risk of bias (RoB2) and Grading of Recommendations, Assessment, Development, and Evaluation tools were applied to assess respiratory muscle strength. Results: Fourteen studies (n = 844) met inclusion criteria (seven with low and seven with a high risk of bias). No trial employed EMST. Thirteen randomised controlled trials (n = 747) reported maximal inspiratory pressure (MIP) in response to IMT. Findings showed low-certainty evidence that IMT increases MIP by 6.9 cmH2O ([95% confidence interval {CI}: 4.9 to 9], i2 = 83%), improving to high-certainty evidence after sensitivity analysis (6.3 cmH2O [95% CI: 3.8 to 8.8], I2 = 34 %, n = 397). IMT was also associated with reduced weaning time (−1.9 days [95% CI: −3 to −0.8], I2 = 76 %, n = 482) and shorter ventilation duration (−1.7 days [95% CI: −3.8 to 0.3], I2 = 32 %). Reductions in rapid shallow breathing index (−6.4 breaths/min/L [95% CI: −16 to 3.2], I2 = 78%) were also observed. Conclusion: This systematic review supports the use of IMT delivered using measurable load devices, initiated during mechanical ventilation, in critical care patients, to increase MIP measures. Other potentially positive effects found in this review such as reduced weaning and mechanical ventilation durations in response to IMT need further confirmation. Registration: This protocol was registered with the International Prospective Register of Systematic Reviews (CRD42023431244)